AB1201 DIGITAL SELF-MANAGEMENT, ANALGESIC USE AND PATIENT-REPORTED OUTCOMES IN KNEE OR HIP OSTEOARTHRITIS
Authors: A. Kiadaliri, S. Lohmander, L. Dahlberg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Despite recommendations for exercise therapy, patient education and weight loss as the first-line treatment for osteoarthritis (OA), analgesics are commonly used to manage pain [1]. <h3>Objectives</h3> To investigate analgesic use among participants of a digital first-line treatment for knee or hip OA. We also explored the associations between analgesics use and pain/function. <h3>Methods</h3> We included individuals participating in the treatment during December 2021–July 2022 with data on analgesic use at baseline and 12-week follow-up (N=4100, mean [SD] age 64.5 [9.3], 73.3% females). Using self-reported data on analgesic use (paracetamol, NSAIDs, opioids, other) during the past month at baseline and follow up, we created a 4-category variable: non-users ("no" at both), persistent users ("yes" at both), quitters ("yes" at baseline and "no" at follow-up) and new users ("no" at baseline and "yes" at follow-up). Data on NRS Pain (0-10, higher value = more pain) and function, measured by the Knee injury/the Hip disability and Osteoarthritis Outcome Score 12 (KOOS-12/HOOS-12) Function subscale (0-100, higher values = better function), were collected. The McNemar test was used to assess the change in analgesic use. Multivariable logistic regression was used to compare characteristics of analgesics users/non-users at baseline. We applied a linear random intercept model adjusted for baseline characteristics to investigate the associations between analgesics use and pain/ function. <h3>Results</h3> Among included participants, 2517 (61.4%) were analgesic users at baseline. Female sex, hip OA, lower education, higher body mass index, living outside three largest metropolitan cities, rheumatoid arthritis, and walking difficulties were associated with higher odds of analgesic use at baseline. From baseline to 12-week follow up, the proportion of analgesic users dropped by 12.0% (95% CI, 10.5, 13.5), from 61.4% to 49.4%. The results of linear random intercept model suggested that at both baseline and 12-week follow up, persons not using analgesics at the time had better outcomes (Table 1). Moreover, all groups but "new users" experienced improvements in their pain and function following participation in digital program with the greatest improvements observed among "quitters". Interestingly, the magnitude of improvements was comparable for "non-users" and "persistent users". <h3>Conclusion</h3> Participation in a digital self-management program for hip or knee OA was associated with 12% drop in analgesic use. Analgesic use was associated with worse pain and function in these people. Greatest improvements were seen for those who stopped analgesic use. Similar results were reported for a face-to-face first-line treatment in Denmark [1, 2]. These results highlight the importance of providing effective first-line treatment to people with hip or knee OA. <h3>References</h3> [1]Thorlund JB, et al. Patients use fewer analgesics following supervised exercise therapy and patient education: an observational study of 16 499 patients with knee or hip osteoarthritis. Br J Sports Med 2021;55:670-675. [2]Koes BW, et al. Does Pain Medication Use Influence the Outcome of 8 Weeks of Education and Exercise Therapy in Patients with Knee or Hip Osteoarthritis? An Observational Study. Pain Med 2022;23:1457-1463. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Ali Kiadaliri Employee of: I acted as a consultant for Joint Academy®, provider of a digital self-management program for osteoarthritis, from August 2021 to December 2022., Stefan Lohmander Employee of: I acted as a consultant for Joint Academy®, provider of a digital self-management program for osteoarthritis, during 2020-2022., Leif Dahlberg Shareholder of: I am founder and chief medical officer at Joint Academy®, providing self-management treatment for osteoarthritis., Employee of: I act as chief medical officer at Joint Academy®, providing self-management treatment for osteoarthritis.